Rising trend in youth sports-related injuries

Thirty million children and teens are busy gearing up for the fall athletic season. What they're not gearing up for is a sprained, strained or fractured ankle. However, US Consumer Product Safety Commission statistics reveal 3.5 million children and teens get hurt annually playing organized and/or school sports. Foot and ankle problems account for one third of all injuries. The American Orthopaedic Foot & Ankle Society (AOFAS) provides parents and coaches with tips and resources for dealing with back-to-school foot and ankle injuries.

Each fall, Ned Amendola, MD, professor of Orthopaedics and Rehabilitation at the University of Iowa College of Medicine, sees an increase in the number of youth sports-related injuries, particularly to the foot and ankle. "Children are at risk for injury when they take a break from sports training or don't prepare enough for the fall sports season. A rapid return to participation in sports such as football, soccer, and long-distance running puts considerable stress on the foot and ankle, significantly predisposing them to injury," explains Amendola.

"There are several factors which lead to a propensity for youth foot and ankle injury. Children's bodies and bones are still in the development stage, therefore, their muscle control and maturity of bones and ligaments are not as stable when subjected to the rigors of competitive sports. In addition, children may be anatomically predisposed to injury due to growth plate attachment to tendons, causing a stress reaction through the growth plate, which for example happens at the attachment of the Achilles tendon to the heel bone," notes Amendola.

The most common youth sports injuries Amendola treats due to overuse are: foot and ankle tendonitis; Achilles apophysitis (inflammation of Achilles tendon, mainly affects 8-15-year-olds); tibialis posterior tendonitis (pain on the inside of the ankle); and stress fractures. Acute injuries including ankle sprains and growth plate fractures are also common in children and require assessment by an orthopaedic surgeon.

Although some injuries are less severe than others, there is always the potential for lifelong medical problems if youth ankle injuries are not initially treated properly. The AOFAS provides parents and coaches with the following ankle injury warning signs and treatment protocol. If you suspect your child has an ankle sprain, follow the R.I.C.E. guidelines:

-- Rest the ankle by not walking on it -- Ice it to keep the swelling down -- Compressive bandages immobilize and support your injury -- Elevate the ankle above heart level for 48 hours

According to the AOFAS, severe sprain can often mask the symptoms of a broken ankle; every injury to the ankle should be examined by a physician. Symptoms of a broken ankle include:

-- Immediate and severe pain -- Swelling -- Bruising -- Tender to the touch -- Inability to put any weight on the injured foot -- Deformity, particularly if there is a dislocation as well as a fracture

Prior to beginning any sports program, Amendola suggests children complete a pre-participation examination by an orthopaedic surgeon to assess any predisposing factors or a pre-existing injury. "If a deformity exists, children might need an adjustment in footwear, or if they have flat foot or cavus foot (high-arched foot), they may benefit from a shoe insert," says Amendola. In addition, "Listen to your child; if he or she starts complaining about pain, an assessment needs to be made to make certain a significant problem does not exist," suggests Amendola.

The AOFAS website, www.aofas.org, contains resources on dealing with injuries ranging from stress fractures, ankle fractures, heel pain, foot pain, and athlete's foot. It also offers ankle sprain rehabilitation techniques which includes strengthening and stretching exercises and "how to" techniques such as how to tape a toe, how to tape an ankle, and how to get back into shape after an injury. The site also features a surgeon referral service, making it easy for parents to find a local orthopaedic surgeon specializing in foot and ankle care.

Orthopaedic foot and ankle surgeons are medical doctors (MD and DO) who specialize in the diagnosis, care, and treatment of patients with disorders of the musculoskeletal system of the foot and ankle. This includes the bones, joints, ligaments, muscles tendons, nerves, and skin. Orthopaedic foot and ankle surgeons use medical, physical, and rehabilitative methods as well as surgery to treat patients of all ages. They perform reconstructive procedures, treat sports injuries, and manage and treat trauma of the foot and ankle.

SOURCE: American Orthopaedic Foot & Ankle Society